Transplanted Hearts and Lungs: Discovering Ways To Keep Them Alive And Growing
The reasons people require lung transplantation are three sets of diseases. One is emphysema which most people are aware is where the lung sort of dilates up. It doesn’t have the ability to really exchange oxygen properly. Sometimes it’s related to cigarette smoking, sometimes it’s related to something you’re born with, you are born with a gene that makes you get that. A second set of diseases are related to what’s called pulmonary hypertension. That is you have pressure in the lungs and that’s either due to something again, you’re born with a tendency to get it or you might have a cardiac defect like a hole between the chambers that causes you to get over pressure in the lungs which becomes irreversible. The final set of defects are things like cystic fibrosis, a disease where the mucus is not created normally in the lungs and as a result it collects and gets infected. It’s a disease mostly in children and young adults.
People started smoking long before anyone knew it was a terrible thing to do and then they got stuck with the habit. Then, even when they give it up, they can’t repair their lungs properly.
The most critical problem facing lung transplant patients today is the ability to get organs for lung transplantation. There’s a real clinical shortage of organs. But there’s sort of two ways of looking at it. We get organs from people who have either had a car accident and their brain has died, or they have a stroke or something of that sort. So obviously we don’t want more people to have car accidents and have strokes and so on.
There’s also a second issue where folks have these and then the family is unwilling to donate. It’s not because they are being mean spirited, but there’s this thing called the selfishness of grief. In other words, you get presented with this terrible disaster, “your loved one is not going to survive,” and then breath two is, “will you donate their organs?” They don’t have time to think about it. It requires a lot of education in this country. The bottom line is there are a lot more people who need these organs than people who are providing them.
Heart Transplants: How to Use Them More Efficiently
The major illnesses leading to the heart transplants in America are all the forms of heart failure, and what we mean by heart failure is someone whose heart muscle is weak. There are two real common kinds in adults. One’s called ischemic, and that means it’s related to having coronary artery disease or hardening of the arteries. And the second kind is called idiopathic, and that means we just don’t know why. And the term we use is cardiomyopathy. So that means basically muscle failure. In children it’s usually related to cardiomyopathy or children who have so-called single ventricles. That is, you are born with one pumping chamber instead of two. And there’s a couple of categories of those that get transplanted.
Clearly smoking plays a role in the ischemics, so if you could avoid getting coronary disease, or put it off, then you’re not going to have a heart attack and injure your heart. The second thing is, if you have symptoms or warning signs of coronary ischemia, which is angina, see your doctor right away and get it dealt with before the heart attack occurs.
Typically, when use a heart it’s when someone has been declared brain dead, and that’s a known criteria for death in this country. There are another group of patients who never meet the criteria of brain dead. Their brain is horribly injured and they have enough injury that their loved ones may want to discontinue support.
Now you can use an organ of someone who is dead from other criteria, that is if their heart stops you can use that organ. So what happens here is the family wants to withdraw support, the ventilator is turned off, the heart stops and then we try to rescue that heart to use it elsewhere.